Spcialist- Insurance Authorisation (Telangana)

Job Title: Insurance Authorization Specialist / Trainer / Supervisor CTC Range
- Specialist: Up to 5 LPA
- Trainer: Up to 7 LPA
- Supervisor: Based on experience and team handling exposure Role Overview The Insurance Authorization team is responsible for ensuring timely and accurate verification of patient insurance eligibility, obtaining prior authorizations, and supporting the overall Revenue Cycle Management (RCM) process. These roles contribute to minimizing denials, improving patient access, and ensuring compliance with payer requirements. Key Responsibilities 1. Insurance Authorization Specialist
- Verify patient insurance eligibility and benefits.
- Initiate and follow up on prior authorization requests with insurance providers.
- Ensure accuracy in patient demographic and insurance information.
- Understand payer guidelines, coverage policies, and authorization requirements.
- Coordinate with internal teams (billing, coding, AR) to resolve authorization-related issues.
- Maintain documentation and ensure compliance with regulatory requirements.
- Assist in reducing denials related to authorization gaps. 2. Trainer – Insurance Authorization
- Design and deliver training programs on Insurance Authorization and RCM processes.
- Train new hires and conduct refresher sessions for existing employees.
- Develop training materials including SOPs, presentations, and assessments.
- Ensure team understanding of concepts such as ICD, CPT, HCPCS, EOBs, and payer guidelines.
- Monitor trainee performance and evaluate training effectiveness.
- Identify skill gaps and implement improvement plans.
- Support process transitions and updates with structured training initiatives.
- Work with operations teams to ensure alignment with business goals. 3. Supervisor – Insurance Authorization
- Manage day-to-day operations of the Insurance Authorization team.
- Monitor team performance, productivity, and quality metrics.
- Handle escalations and ensure timely resolution of authorization issues.
- Analyze denial trends and implement corrective actions.
- Ensure adherence to SLAs, compliance standards, and process guidelines.
- Conduct team reviews, coaching sessions, and performance appraisals.
- Collaborate with cross-functional teams to improve workflow efficiency.
- Drive process improvements and automation initiatives. Eligibility Criteria Education
- Bachelor’s degree in any discipline (mandatory).
- Preferred: Life Sciences / Pharmacy / Nursing background (for Trainer role). Experience
- Specialist: 1–3 years in healthcare/RCM/Patient Access.
- Trainer: 3+ years overall with minimum 2+ years in training (RCM/Healthcare).
- Supervisor: 4–7+ years with team handling experience in Insurance Authorization/RCM. Required Skills & Competencies
- Strong knowledge of Insurance Authorization, Eligibility Verification, and RCM lifecycle.
- Understanding of medical terminology, CPT, ICD, HCPCS codes.
- Familiarity with payer guidelines and managed care processes.
- Analytical mindset with problem-solving abilities.
- Proficiency in MS Office (Excel, Word, PowerPoint).
- Excellent communication and interpersonal skills.
- Ability to work collaboratively in a team workplace. Apply on Kit Job: kitjob.in/job/4na8l3